In February 2016, former South Carolina Governor Nikki Haley, Nurse-Family Partnership, and Social Finance launched the nation’s first Pay for Success initiative aimed at improving health outcomes for mothers and children living in poverty. The program expanded Nurse-Family Partnership’s evidence-based program to an additional 3,000 first-time mothers with low incomes, and their young children, across South Carolina. The program supported these mothers by helping them maintain healthy pregnancies and become knowledgeable, responsible parents so they could give their children the best possible start in life. This project aimed to spark multigenerational change and help break cycles of poverty by strengthening families and improving early childhood development.
The initiative mobilized $29 million to expand Nurse-Family Partnership’s services. Philanthropic funders committed $17 million to the project and Medicaid funded approximately $12 million via a 1915(b) Medicaid Waiver, awarded to the South Carolina Department of Health and Human Services (SCDHHS) by the federal Centers for Medicare and Medicaid services. South Carolina agreed to make up to $7.5 million in success payments if the evaluators found positive results, 100% of which would be reinvested in the program.
Goals
Create long-term, lasting results for families statewide by supporting first-time mothers to have healthy pregnancies and become great parents, setting up children for successful early childhood development in rural and urban areas across the state.
Build a pathway for sustaining these effective services through reinvesting state success payments into the program and partnering with Medicaid.
Use a rigorous evaluation to understand the efficacy of the Nurse-Family Partnership model after implementing strategies to improve delivery and lower costs, providing important insight on how to best scale this program.
Bring an added level of government accountability for results for the families served.
Participant Stories
A Home Visiting Nurse Helped Taquana Navigate Pregnancy and Beyond
Taquana enrolled with Nurse-Family Partnership in 2019 and was matched with nurse Kenyetta, who helped her throughout her pregnancy. “My nurse was there for me every step of the way,” Taquana said. “I could text her when I was feeling down, and she was always there.”
How It Works
This innovative program is going to allow us to improve the health of our children and families, and it’s a perfect example of what we can do when leaders from the private sector and public service work together.
Former South Carolina Gov. Nikki Haley
Interim Results
The project concluded April 1, 2021, with J-Pal North America (J-PAL), the project’s independent evaluator, publishing an interim evaluation report indicating that NFP did not have an impact on the four preselected Pay for Success outcomes.
The interim results for the three outcomes, preterm births, healthy birth spacing, and child injury, measured by randomized control trial, only captured outcomes for a subset of the enrolled clients and were not statistically significant, meaning there was no distinguishable difference between the results for the families that received NFP services and those who did not. However, this does not mean that the project had no impact on the mothers and children that were served.
A more comprehensive assessment of NFP’s impact will emerge through J-PAL’s longer-term evaluation, which will continue for 30 years. Learn more on the study’s website.
Nurse-Family Partnership received funding to expand its evidence-based home visitation program to serve an additional 3,200 low income first time mothers.
Social Finance supported the design, negotiation, and financial structuring of the project; managed the capital raise; and is coordinating performance management services for the duration of the project.
Harvard Government Performance Lab advised the SCDHHS throughout the phases of project development, including project design, data analysis, and contract negotiations.
![A mother holds her daughter while they share a laugh outside in the greenery.](https://socialfinance.org/wp-content/uploads/2020/07/terri-e1669835019949-1000x1000.jpg")
![Three black women and a child pose for a photo in the woods.](https://socialfinance.org/wp-content/uploads/2018/02/Untitled-design-1-1000x1000.png")
